Permit Pri .c,i 2 25.0c(
a CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00436
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/24/2008
PARCEL: 2 S 102 B D -032 00
SITE ADDRESS: 13075 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT: 035 JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Replacing existing fixtures with new. 12/11/2008 ADDED 60 ft. of water line and (1) 2" floor drain.
2/19/09, adding 130' of storm service to 20' bio- diffuser at rear of property.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: 130 ft
Owner: FEES
ESTATE OF SHULER, GARRY COUEY
30790 NE FERNWOOD Description Date Amount
NEWBERG, OR 97132 [PLUMB] Permit Fee 11/24/200€ $99.60
[TAX] 12% State Surch 11/24/200€ $11.95
Phone : [PLUMB] Addl Permit 12/11/200€ $72.50
[TAX] 12% State Surch 12/11/200E $8.70
[PLUMB] Addl Permit 2/19/2009 $101.40
Contractor: [TAX] 12% State Surch 2/19/2009 $12.17
BRUNER PLUMBING (additional fees not shown here)
PO BOX 23985
TIGARD, OR 8 97281 REQUIRED TIVflAS AND RI M%
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
App caa oY Cdr c a 1 ►n al
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
u •
R.
v CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PE
COMMUNITY PLM2008 -00436
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11!24/2008
PARCEL: 2 S 102 B D -032 00
SITE ADDRESS: 13075 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT: 035 JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Replacing existing fixtures with new.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ESTATE OF SHULER, GARRY COUEY
30790 NE FERNWOOD Description Date Amount
NEWBERG, OR 97132 [PLUMB] Permit Fee 11/24/200€ $99.60
[TAX] 12% State Surch 11/24/200€ $11.95
Phone : Total $111.55
Contractor:
BRUNER PLUMBING
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB .
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these ru or direct q i : tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is d By: . / �` l j Permittee Signature. ' j i °� 1 r 0
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application S_A L Al Zc»g - 0 J y 3 6
City of Tigard RECEIVED Received
g Permit No.:
• 13125 SW Hall Blvd., Tigard, OR 97223 A t � 2009 Date/By: C • Phone: 503.639.4171 Fax: 503.598.1960JUN 2 Plan Review
Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date ReadyBy: Juris: 0 See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF WORIISUILDING DIVISION FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION -• SFR (I) bath 249.20
❑ 1- and 2- family dwelling O'Commercial /industrial SFR (2) bath 350.00
Accessory building SFR (3) bath 399.00
❑ ry g ❑ Multi - family
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
• JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /36) 7c SO /e(,7 c .-- /1--> Catch basin or area drain , 16.60
City /State /ZIP: fi7794,...,•.(e 0 R ° T 7Z2- 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: S ayi 0/4 e Footing drain (no. linear ft.: ) Page 2
a/./4.__ 5.÷- Manufactured home utilities 1 10.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2 •
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: • ) Page 2
Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
•
. 1�ESCRIPTION OF WORK
,, - n C/� 4 Backflow preventer Page 2
L�GA. _ h'ita f fri ft>/
Col Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
❑ PROPERTY OWNER ❑ TENANT Ejectors /sump 16.60
Name: Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ' ❑ CONTACT PERSON. , Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name:
Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( )
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60 •
CONTRACTOR Water closet 16.60
Business name: r j r U Y) et/ r tU h� 1 /2e /h Water heater 16.60
Address: / 0 , 6 239 g __) Other:
City /State /ZIP: 779 . ( / c i � °77 Z � ^ crr Subtotal
'Minimum permit fee: $72.50 •� co
Phone: (] p3) y_ r/ t,' 0 Fax: ($p3) 6Z�- 21 7'3 Residential backflow minimum permit fee: $36.25
CCB Lic.: 7 / ??3-7 Plumbing Lic. no.: Z(„ - y AQ Plan review (25% of permit fee)
State surcharge (12% of permit fee) g',-7'
Authorized signature: 18 ..„`� q
TOTAL PERMIT FEE
Print name: / ,�,�� e y y�„� Date: „/ 2 3�g This permit application expires if a permit is not obtained within
"� ( / 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1 1Building\Perm its \PLM- PermitApp.doc 12/27/06 440- 4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities - Qty.. • 'Fee (ea) Total - Square Footage Permit Fe e: ,
Footing drain - I' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty- Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
•
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", 'Plan Review for Plumbing Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
'Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped Added Existing, engineer. -
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
-Tub/Shower as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive tall ❑ Any multipurpose fire sprinkler system.
Cuspidor water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric or Riser Diagram
Floor Drain /sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink Bar/Lavatory *Note: If the fixture work under this ermit results in an
- Bradley p
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i:\Building\Permits\PLM- PermitApp.doc 12/27/06
•
• Building Fixtures •
Plumbing Permit Application
City of Tigard Permit No.: L e- 30 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Receiv
Phone: 503.639.4171 Fax: 503.598.1960 / /��,c ,y: i • \ Date/By. Other Permit No.:
24- Hour Inspection Line: 503.639.4175 _ l Date Ready/By. ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method / go Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
jEr Add ition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /3 7 5 s(,J , /h. c Fl , I Catch basin or area drain 16.60
City /State /ZIP: - 7" ; / (' 2 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: / ' / Project name: ' S Z_ Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: • kr, r72.4.1 4- Manholes 16.60
Rain drain connector 16.60
•
' Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve J 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
re,t/vt c) c� CX. 1.1) t -..-._ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
6dAPPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
. Business name: •
Interceptor /grease trap 16.60
Contact nam & E S NG lam?/ Medical gas (value: $ ) Page 2
Address: l 0D 60 s W o '� 1 _ Primer 16.60
1 � 9 W D �
City /State/ZIP: Roof drain (commercial) 16.60
9 3
Phone: (.5 03 ' �, 1 0 /' l , ' I Fax: ( ) Tub/shower/shower how 16.60
. c� V Tub /shower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet .Z 16.60
Business name: jZ J 4 e /I , ,, b.,,_. Water heater / 16.60
! `
Address: v A z - 2.,c 7 g Other:
City /State/ZIP: T/,9 � O Z c j 7Z' I • 3 9 Y - Subtotal
Minimum permit fee: $72.50 Q
Phone: (5 (33) C, Z� SC a-,e LD Fax: (.5 o3) 6 Z y a --1-. Residential backflow minimum permit fee: $36.25 /
CCB Lic.:
�� b Plumbing Lic. no.: 2 S g Pc' Plan review (25% of permit fee) - 0
Authorized signature: State surcharge (8% of permit fee) f 1 • ¢5
�� t / TOTAL PERMIT FEE // / • �
Print name: � d 2
i v_ vt �� I Date: /'� f � O7 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
is\ Building \Perm its \PLMF- PennitApp.doc 06/05 440-46I6T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
Sewer - 1st 100' 55.00 3,601 to 7,200 $220.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back flow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or
each additional $100.00 or fraction thereof to
. specially requested inspections -per hour 72.50 and including $50,000.00.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool , providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
• Drinking Fountain ❑ Any NFPA 13 - multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink - 2" Submit .2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal -Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor P
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
i : \ Building \Petmits\PLM- PetmitApp.doc 07 /06/05
, ,,,... 41(6 .. , .5% ,4k.,..., • - 0,„ .
.7 u ,CITY' . TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00436
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/24/2008
PARCEL: '2S102BD -03200
SITE ADDRESS: x0.75 -SW- PACIFIC- HWVY - , . ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT: 035 JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Replacing existing fixtures with new. 12/11/2008 ADDED 60 ft of water line and (1) 2" floor drain.
2/19/09, adding 130' of storm service to soakage trench at rear of property.
•
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: 130 ft
•
Owner: FEES
ESTATE OF SHULER, GARRY COUEY
30790 NE FERNWOOD Description Date Amount ' •
NEWBERG, OR 97132 [PLUMB] Permit Fee 11/24/200E ' $99.60 ,
• • [TAX] 12% State Surch 11 /24/200E , $11.95
Phone : [PLUMB] Addl Permit 12/11/200E $72.50
[TAX] 12% State Surch 12/11/200E $8.70
[PLUMB] Addl Permit 2/19/2009 $101.40
Contractor: • [TAX] 12% State Surch 2/19/2009 $12.17
BRUNER PLUMBING Total $306.32
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -4880
FAX . 503 =624 -2173 . '
Reg #: LIC 81837
PLM 26 -445PB
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law.requires you to follow rules adopted by the Oregon
Utility Notif • enter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these r es or direct es • to UNC by calling 503.246.6699 or 1.800.332.2344.
1 / --- . __ cre:ei, .
Issu d By: ' Permittee Signet aft i / t
, Call 503.639.4175 by'7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
r .. Plu -mbin2 Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received � 4 v ! Date/By: y
Date /By: / f / eve
:6
No 1 L ,N� /v6
• 13125 SW Hall Blvd., Tigard, OR 97223
Pl
C Phone: 503.639.4171 Fax: 503.598.1960 an Review
Dan Other Permit No.:
l' I G n It D Inspection Line: 503.639.4175 Date Ready/13y: r ®See Page 2 for
Internet: www.tigard -or.gov Notified/Method: I(Cj Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
El 1- and 2- family dwelling El Commercial /industrial SFR (2) bath 350.00
❑ Accessory building CI Multi-family SFR (3) bath 399.00
El Master builder ach additional bath/kitchen 45.00
Cl ❑ O ther: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION LOCATION Site utilities
Job site address: / 76- t /9-c . t'� Catch basin or area drain 16.60
City/State/ZIP: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: t(1 o a 5,p ,� e _ Footing drain (no. linear ft.: ) Page 2
f"'_ / - Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear e ft: Page 2
Storm sewer (no. linear 9f Page 2 M(. I P
Subdivision: I Lot no.: Water service (no. linear ft.: _) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
-
� G .3/ ev L , , Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: L._,.� e& S c,,,h , Expansion tank I 16.60
Address:
Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: n c ,„.__ et L/�+� - /-,..1t.___. Water heater 16.60
Address: D- _ I l, ,, 2,.....e7/ 2rg� O ther: -
City /State /ZIP: Subtotal
/0�6t ""� �� c) Minimum permit fee: $72.50 I ' [
Phone: (5,i 6 3 6 Fax: 5::.-.3) ,�,/ 2 , .( 7 g Residential backflow minimum permit fee: $36.25 ( • "I
CCB Lic.: 8/s,..-- _ -2 Plumbing Lic. no.: 2 �i ft..5 e'g Plan review (25% of permit fee)
v State surcharge (12% of permit fee) l2..i,
Authorized signature:
. s a TOTAL PERMIT FEE // 3...5
Print name: 4 v6k 67,,,....._ Date: Z�7o This permit application expires if a permit is not obtained within
/ 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry Service Board.
1:\Building\Permits\PLMF- PermitApp.doc 12/27/06 4404616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard '
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
-Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
is\ Building \Permits\PLM- PermitApp.doc 12/27/06
/ail ' U y 4r?iv1c,Srr»7L: gota / Gt. l ' , 'ce. vr- rtt:xrr c.ircul"
• , . 7 4
CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00436
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/24/2008
PARCEL: 2S 102 BD -03200
SITE ADDRESS: 13075 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT: 035 JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Replacing existing fixtures with new. 12/11/2008 ADDED 60 ft. of water line and (1) 2" floor drain.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ESTATE OF SHULER, GARRY COUEY
30790 NE FERNWOOD Description Date Amount
NEWBERG, OR 97132 • [PLUMB] Permit Fee 11/24/200E $99.60
[TAX] 12% State Surch 11/24/200E $11.95
Phone : [PLUMB] Addl Permit 12/11/200E $72.50
[TAX] 12% State Surch 12/11/200E $8.70
Contractor: Total $192.75
' BRUNER PLUMBING
PO BOX 23985
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 624 -4880
FAX 503- 624 -2173
Reg #: LIC 81837
PLM 26 -445PB
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By ii` . ______ Permittee Signature: .,:
IOW
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
o
Building Fixtures 1 11 F OR OFFICE USE ONLY
` /
City of Tigard , R Date/By: 1)/�� U (� L - PermitNo.: 9 ajg j (..3h
II a 13125 SW Hall Blvd., Tigard, OR 97 • "' cil
Phone: 503.639.4171 Fax: 503.598.',`6 10.. "'�, Plan Review '
•
Other Permit No.� - 139 Inspection Line: 503.639.4175 �. ' . `� e/By: -
T I G A R p O `� + dyBy: runs: ® See Page Z for
Internet: www.tigard - or.gov t)* IN
Supplemental Information
TYPE OF WORK d ic 0 a _‘1 FEE* SCHEDULE
❑ New construction ❑ Demo010 For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath • 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND L CATION Site utilities
Job site address: Catch basin or area drain 16.60
City/State /ZIP: �r rte„/( t�� Drywell, leach line, or trench drain 16.60
Suite/bldg.Japl not: -- • - " Project name: - - y r ... . Footing drain.(no. linear ft.: ) _ Page 2
`'` ` Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
• Sanitary sewer (no. linear ft.: ) Page 2
• Storm sewer (no. linear ft.: ) Page 2 '
Subdivision: Lot no.:
Water service (no. linear ft.: i Page 2 ��
Fixture or item
• Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
,t..1 l CO 13 - d t ,v if /Al°C e, Cil� 4 Backwater valve 16.60
iou defw
t+ l )J Clothes washe 16.60 -
17�"
Dishwasher 16.60
OD Galth'� . -e` i Sh rr1
❑ PROPERTY OWNER 0 TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Expansion tank 16.60
Address: Fixture /sewer cap - 16.60
City /State /ZIP: Floor drain/floor sink/hub T f 16.60 /
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60 ,
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ' ) Page 2
Address: Primer 16.60
City/State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: 5.74 /J� .6 � Water heater 16.60
Address: Other: •
City/State /ZIP: Subtotal
Minimum permit fee: $72.50 t
Phone: (• ) Fax: ( ) . Residential backflow minimum permit fee: $36.25 -71-
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) Vt. - /0
Authorized signature: TOTAL PERMIT FEE F'`iaV
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1:\ Building \Permits\PLMF- PermitApp.doc 12/27 /06 440- 4616T(IU /02/COM/WEB) 391 '
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information • '
Fee Schedule: .Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I n 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3 ",601,to 7,200 $220.00
Sewer - 1st 100' r 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i'\ Building \Permits\PLM- PermitApp.doc 12/27/06
•
BRUNER PLUMBING
P.O. BOX 23985
TIGARD, OR 97223 a cl Do ( /I P(avi (fiD SC4-k)
624-4880
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•
CITY OF TIGARD �'.
BUILDING DIVISION ) b3 b PERMIT #: Pi.M2t)418 0 '136
13125 SW Hall Blvd., Tigard, OR 97223 hh l DATE ISSUED: f '� 8
Phone: (503) 639 -4171 ,o 1 V ' 3 E
Inspection Requests (24 Hrs.): (503) 639 -4175 'I l
INSPECTION WORKSHEET FOR DATE: 2/26/2009 TIME: 7:03AM PAGE: 6
SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NORTH "HGARDVILLI ADDITION LOT #: 035 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Replacing existing fixtures with new. 12/11/2008 ADDED 60 EL of water Tine and (1) T floor drain.
2/19/09, a adding 130' of storm service to 20' bio-- diffuser at rear of property.
OWNER: ESTATE OF SHULER, CARRY COUEY, PHONE #:
CONTRACTOR: BRUNFR PLUMBING PHONE #: 6'03. 624 - 4880
Inspection Request Scheduled For: Date: 2f26l12009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 080872 -01 503-624-4880 N
Corrections /Comments /Instructions: c--r O Aio 6e-qc bu,.._ 0,__j
1 vi 4 — . ' tom-« Z
- t - . Lt.)---t ;—e aue- . _ • 1 ,
/44--l—j
9 -vvk
. , . -- 7 4 °- 52- .__sr...i tr" ' A
.,-/-"is6L-efecif--01;1, 4 -0--4___ (.5 2-d--e:s -
J
P AS T1/1 •ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1\Z-:- �/�' Date:)' Phone #: (503) 718 - c)-j4"/>/i
CITY OF TIGARD ,_ w ' 1
BUILDING DIVISION \\� P . Pt-M2008- 004:36
13125 SW Hall Blvd., Tigard, OR 97223 l DAT UED 11/24/20 18
Phone: (503) 639 -4171 4 y i,q .! , l �
Inspection Requests (24 Hrs.): (503) 639 -4175 e'II V�
± 1`
t.....c.__
INSPECTION WORKSHEET FOR DATE: 25/2009 TIME: 7 :00AM PAGE: 13
SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 035 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Replacing existing fixtures with new. 12/11/2008 ADDED 80 ft. of water line and (1) 2' floor drain.
2/19/09, adding 130' of storm service to soakage trench at rear of property,
OWNER: ESTATE OF SHULER, CARRY COUEY, PHONE #:
CONTRACTOR: BBRUNER PLUMBING PHONE #: 603.624 - 4880
Inspection Request Scheduled For: Date: 2`25/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
(336 ') Rrin drain alA, , 0130841 -01 503.6244880 N
Corrections /Comments /Instructions: ,�, �� V & !
fV11\A/-YX--ft ........ A.
1\ 7 1)-6 --i,o A._ A, a k W 'CI 6 -0i V2A
. ■ ✓ /� ` ru ,r G /"—A-
( -34 6 ) \( Ze/ LW .- gr 4 tAA/
3 q e-C7 6- ._ Q —
41 <c•-ie-i4A- ,
TKPA : VrARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I* CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ‘4,/ `/ V 2/2<7 C I Phone #: (503) 718 - /
CITY OF TIGARD - �' -` __�
BUILDING DIVISION / 9D-
PERMIT #: PLM200B- 0CNi36
13125 SW Hall Blvd., Tigard, OR 97223 v n[ DATE ISSUED: 11/24/20013
Phone: (503) 639 -4171 ! 4pu tii " 1 I 1
Inspection Requests (24 Hrs.): (503) 6394175 - '_.
_. 0 6 ��_
INSPECTION WORKSHEET FOR DATE: 2/6/2009 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 13075 SIN PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVIL.LE ADDITION LOT #: 035 TYPE OF USE:
PROJECT NAME: :;SPEC SPACE
DESCRIPTION: Replacing existing fixtures with new, 12/11/2008 ADDED 60 ft. of water line and (1) 2" floor drain.
OWNER: ESTATE OF SHULER, GARRY COLEY, PHONE #:
CONTRACTOR: BRUNER PLUMBING PHONE #: 503.624 4f380
Inspection Request Scheduled For: Date: 29/2008 Pour Time:
Code # Inspection Descripti n clo ut . , Confirm # Contact # Mes
395 Misc. inspection ✓ • 080416 -01 503 - 52448£30
Corrections /Comments / Instructions:
1 `
P r k Al L 1(
�1.
(l PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 - D/91
P (
Rick Bolen
To: Albert Shields
Subject: PRJ2008 -00616
Albert,
13075 Pacific Hwy is calling in for their Final Building Inspection. Last week, I informed the owner that there is an issue
with the Rain Drain System run -off onto the public way in front of the building. Since there wasn't a prior Rain
Drain /Storm System and with it now becoming an issue, I told the owner that they would have to correct it before the
Plumbing Final. I also spoke to Ward of Bruner Plumbing and reiterated the same thing. Ward is proposing that the
Rain Drain /Storm System go to Pacific Hwy. I explained to Ward that I am reluctant to approve this application with not
knowing that there is a Storm Basin along Pac. Hwy. I will run by sometime today and check it out. Ward will be
contacting you regarding this issue. He will also bring in a plot showing how he is proposing to do the Rain Drain /Storm
System. I am okay with anything better than what is there.
I am going to cancel both inspections called in for today.
I also spoke to the owner about the handicap parking. He is proposing that he can do this in front of the building. If he
did, he would have to place the parking lane and protected zone parallel with the building, which actually enters onto
the front entry. I asked that he come in and speak to you about this issue. I also asked that he draw it up and submit a
plan schedule to show how it is to be done. If the parking is to be placed in the rear, then there would have to be
corrective measures to move around the already existing steel door that leads to the basement, which would put the
person into the traffic lane of their driveway.
Rick
1
CITY OF TIGARD
_ Iiir
BUILDING DIVISION PERMIT #: NhtOa evel
13125 SW Hall Blvd., Tigard, OR 97223 a DATE ISSUED:
Phone: (503) 639 -4171 a j p Z3 )
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' ,. �,__ t ,. (� 4 A
INSPECTION WORKSHEET FOR DATE: a (p /0c TIME: PAGE:
SITE ADDRESS: ( 307 5 o t!J P'-et Gs C 44-i-4->)( CLASS OF WORK: 44 .- - r -
SUBDIVISION: LOT #: TYPE OF USE: dof-f
PROJECT NAME: ' `ake dP�C4.
DESCRIPTION:
OWNER: / PHONE #:
CONTRACTOR WPra ►J4 /6Q p ly e1/4* PHONE #: - 03,. (40,..5.
Inspection Request Scheduled For: Date: Pour Time:
Code # 39 Inspection Description Confirm # Contact # Message
Corrections /Comments /Instr tions:
0
-1e-r > / D'e
il
'' '-- = 1 i 44 . _....k: l --- 7,L.,4 .A.-*' 4,--■...--
"`_,. /i 4
, 4 .( ,, j )-c" - ' ' ir■___, 5
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Fe-/q U - 4 \ d-N1, l' .-- i� A- -_ �!
f - 4 4 CS ._.0 /. •
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t K FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
.....u?
Inspector: V Date: ) Phone #: (503) 718 - 2-q.)--`1
_ ___. ....
1
CITY OF TIGARD J.11
• , -1
A __
BUILDING DIVISION . ,
L f , PERMIT #: Pi..M2008-00436
13125 SW Hall Blvd., Tigard, OR 97223 te; qo DATE ISSUED: 11/24/2008
. -f/ifoe
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
7:00Alvf
INSPECTION WORKSHEET FOR DATE: 12/29/2008 TIME:. PAGE: 12
SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: on TYPE OF USE:
PROJECT NAME: spa; spAcE
DESCRIPTION: Replacing exictiiig fixtures with new. 12/11/2008 ADDED 60 ft. of water line and (1) r floor drain.
OWNER: ESTATE OF SHULER, GAF COUEY, PHONE #:
....
CONTRACTOR: BRUNER PLUMBING PHONE #: 503-624-4880 .
Inspection Request Scheduled For: Date: 12/2911008 Pour Time:
Code # / Ifispection Description Confirm # Contact # Message •
320 Plumbing rough-in 079228-01 503-624-4880 N
Corrections/Comments/Instructions:
i & I 'ASS 0 PARTIAL APPROVAL El CANCEL 0 NO ACCESS
fl FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
. (1 1...
Inspector: ..
/
. Date: I 1='hone #: (503) 718- )4
1 •
., .
( � J
CITY OF TIGARD �;, - .r- . ‘ 1 �
BUILDING DIVISION / ! / MIT #: M12008-00436 13125 SW Hall Blvd., Tigard, OR 97223 T E ISSUED: 11124/2008
u
Phone: (503) 639 -4171 ' ' l' �2
Inspection Requests s 2 4 Hrs.): (503) , 639 -4175 !.!,L ; / I
INSPECTION WORKSHEET FOR DATE: 12/19/200B TIME: 7 f)0AM PAGE: 16
SITE ADDRESS: 1307'i SW PACIFIC IiWY CLASS OF WORK:
SUBDIVISION: NORTH *TIGARDVII.I..E ADDITION LOT #: 035 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Replacing existing fixtures with new. 12/11/2009 ADDED 60 ft. of water line and (1) 2" floor drain.
OWNER: ESTATE OF liULER, GARRY COUEY, PHONE #:
CONTRACTOR: BRUNER PLUMBING PHONE #: 603 - 624- 4660
Inspection Request Scheduled For: Date: 12/19/2008 Pour Time: -
Code # Inspection Description Confirm # Contact # M a-: age
320 Plurnhing rough -in 079153 -01 503 -624 -4880 'Y ey0
Correctio s/ m� /In ructions: c,t,
i
'/ /VVV
1 J
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, ,
•
71 1,y , --- / 4 .s - - v 1 f 2 , 7 _ , di ( C2,42
1
4 - / _ L t .S / , r 31. c,.1 . .
1 PAS ARTIAL APPROVAL [11 CANCEL ❑ NO ACCESS r.
n FAIL ' � n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
' t)vb-- .
,,,
Inspector: D ate: 0 I Phone #: (503) 718 -
0
CITY OF TIGARD A :� =.. --v BUILDING DIVISION 1 PERMIT #: PLlv17008- 00436
13125 SW Hall Blvd., Tigard, OR 97223 �� DATE ISSUED: 11/24/2008
Phone: (503) 639 -4171 .. 11
Inspection Requests (24 Hrs.): (503) 639 -4175 .-'Wr 1
INSPECTION WORKSHEET FOR DATE: 12/1212008 TIME: 7:00Am PAGE: 20
SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 035 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: F2eplacing existing fixtures with new. /2111/2008 ADDED 60 ft. of water line and (1) 2" floor drain. .
OWNER: ESTATE OF SHULER, GARRY COUEY, PHONE #: '
CONTRACTOR: BRUNER PLUMBING PHONE #: 503.64 -4880
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Inspection Request Scheduled For: Date: 12/12120083 , \I Pour Time: 6443 6
Code # Inspection Description Confirm # Contact #" Me • •
330 Water service 078003.02 503-624-4880
Corrections /Comments /Instructions: LL
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t li PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: Date:
P hone #: (503) 718
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